关节镜十字缝线桥固定肱骨大结节骨折Arthroscopic cross suture bridge for humeral greater tuberosity fractures
王俊;黄建明;刘好源;叶志扬;谢德胜;
摘要(Abstract)：
[目的]介绍关节镜十字缝线桥固定大结节骨折的手术技术与初步临床效果。[方法] 2017年07月～2019年11月,本科对16例初次肩关节脱位合并肱骨大结节骨折的患者,进行急诊手法复位,并于复位后2～5日,行关节镜下十字缝线桥技术对肱骨大结节骨折复位固定。男性12例,女性4例,年龄18～40岁,其中,2例合并Slap损伤,4例合并Bankart损伤,均同时以锚钉缝线固定。[结果] 16例患者均顺利手术,无神经损伤,切口均为Ⅰ/甲愈合。随访时间1年,随术后时间推移,16例患者的Constant-Murley评分显著增加(P<0.05)。术后影像检查显示大结节骨块恢复正常解剖位置,至末次随访时,所有患者骨折端均达骨性愈合。[结论]十字缝线桥技术能更好的恢复肱骨大结节的解剖位置,避免外旋、上抬无力及肩峰撞击等并发症。
关键词(KeyWords)： 肱骨大结节骨折;十字缝线桥;Mutch分型;关节镜
基金项目(Foundation): 厦门市创伤骨科重点专科，厦门市优势亚专科建设项目（编号：3502Z20194052）
作者(Author): 王俊;黄建明;刘好源;叶志扬;谢德胜;
Email:
DOI:
参考文献(References)：
- [1]Green A,Izzi J.Isolated fractures of the greater tuberosity of the proximal humerus[J].J Shoulder Elbow Surg,2003,12(6):641-649.
- [2]Neer C,Neer C,Neer CN,et al.Displaced proximal humeral fractures:Part I Classification and evaluation[J].Clin Orthop,2006,442(442):77-82.
- [3]Mutch J,Laflamme GY,Hagemeister N,et al.A new morphological classification for greater tuberosity fractures of the proximal humerus validation and clinical impications[J].J Bone Joint Surg Br,2014,96/B(5):646-651.
- [4]Skyhar MJ,Altchek DW,Warren RF,et al.Shoulder arthroscopy with the patient in the beach-chair position[J].Arthroscopy,1988,4(4):256-259.
- [5]David WN,Ujash S,Kristina C,et al.The true recurrence rate and factors predicting recurrent instability after nonsurgical management of traumatic primary anterior shoulder dislocation:a systematic review[J].Arthroscopy:S0749806316303279.
- [6]Longo UG,Van d LJA,Loppini M,et al.Surgical versus nonoperative treatment in patients up to 18 years old with traumatic shoulder instability:a systematic review and quantitative synthesis of1324the literature[J].Arthroscopy,2016:S0749806315008786.
- [7]Longo UG,Loppini M,Rizzello G,et al.Management of primary acute anterior shoulder dislocation:a systematic review and quantitative synthesis of the literature[J].Arthroscopy,2014,30(4):506-522.
- [8]马蔓,王艳华,张晓萌,等.肱骨大结节骨折内固定的生物力学研究进展[J].中华肩肘外科电子杂志,2019,7(1):88-91.
- [9]Ji JH,Jeong JJ,Kim YY,et al.Clinical and radiologic outcomes of arthroscopic suture bridge repair for the greater tuberosity fractures of the proximal humerus[J].Arch Orthop Trauma Surg,2017,137(1):9-17.